Q: What causes pain/discomfort
when eating sweet fruit like
watermelon
on an empty stomach?

Don Bennett replies:

Discomfort/pain from eating a meal of just fruit can be
caused by a number of factors (and possibly by a combination of some of
them; i.e. primary and secondary causes)...
* the fruit wasn't fully ripe
* the fruit was too cold (came right out of the refrigerator)
* you ate too fast (don't eat when rushed)
* you were upset while eating
* you were tired and really needed sleep and not food
* you weren't ready for a meal but ate anyway (before the
previous meal had "moved through")
* you combined other foods that don't go well with the fruit
(from a digestive perspective)
* there's too much fat in your diet (carb processing/utilization
can be impared)
* if you ate different fruits at the same meal, you ate denser
ones before the more watery ones
* you stuffed yourself with fruit in an effort to get enough
calories when you have a
sluggish digestive system
* overall poor health that has affected certain organs (like
the pancreas which regulates cell
sugar uptake; eating some leafy greens before
and after the sweet fruit can help here)
These are the issues that get the most press. But one factor that is often
overlooked is a deficiency of a nutrient(s) that plays a part in the proper
digestion and/or assimilation of the fruit, and that's what this article
will address.

A possible reason for discomfort or pain after eating
a mono-meal of sweet fruit has been shown to be a lack of sufficient chromium
in the diet. Chromium is known to enhance the action of insulin, which
is a hormone critical to the metabolism and storage of carbohydrate, fat,
and protein in the body.

Some History

Chromium was identified as the active ingredient
in the so-called "glucose tolerance factor" in 1959. Chromium
also appears to be directly involved in carbohydrate, fat, and protein
metabolism. In the 1960s, chromium was found to correct glucose
intolerance and insulin resistance in deficient animals, two indicators
that the body is failing to properly control blood-sugar levels
and which are precursors of type 2 diabetes.

I have verified this chromium-blood sugar regulation connection
a number of ways. I had this problem myself, often referred to as "melon-belly"
(but more painful forms could be described as a "fruit attack").
Mine was a relatively mild case. I could not eat a decent sized meal of
watermelon without getting some discomfort. The symptoms of melon-belly
can vary in intensity and are therefore sometimes described as different
symptoms, but they can be the same symptom, just different degrees of
it. Some general descriptions are: fatigue to varying degrees a little
after eating, and pain in the abdominal area or chest area, sometimes
severe in severe cases. These subside in anywhere from 15 minutes to hours.

While it's usually associated with high water content
sweet fruit, some people get melon-belly even when eating bananas or other
sweet fruit.

Experiments on myself and then with those I've counseled
over the years, has resulted in the inescapable conclusion that, for melon-belly,
lack of sufficient chromium in the diet is a root cause. Because there
is no chromium-specific enzyme or other biochemical marker to reliably
assess a person's chromium status, currently there is no valid and reliable
test for chromium, so you can't check to see if you've got enough (just
like with most food-provided nutrients). But there is a simple test you
can do at home that is diagnostically revealing. More on this in a moment.

Some people say to simply eat more of the foods that are
good sources of chromium, but dietary intakes of chromium cannot be reliably
determined because the content of chromium in foods is substantially affected
by agricultural growing and harvesting practices, and perhaps by contamination
with chromium when the foods are analyzed in lab. So the lists of foods
that are good sources are actually lists of foods that are supposed
to be good sources. But consider that I had been eating plenty of the
"best" sources of chromium  lettuce and tomatoes, and
still became deficient in chromium. [If the soil something is grown in
is deficient in a particular nutrient, the foods that are grown in that
soil will be too. Please see this
article and video for an in-depth explaination why the fruits and
green leafies we are buying fall into this category. And for a reason
why nutritional intake and adequacy results from Cron-O-Meter and Fitday.com
may not be reliable, read this
article.]

When I first encountered melon-belly, I had inquired of
raw food educators as to its cause, but the general consensus was "we
don't know". Since I loved watermelon, and since I should be able
to eat it without discomfort, I was determined to discover the cause.
If there was one thing I had learned from my health research thus far,
it was that the answer is knowable IF you're looking for it from the right
perspective.

I will preface this "test" by saying that I
do not recommend taking individual nutritional supplements from A to Zinc
(with the exception of D and B12). Doing so can get you into a boatload
of trouble, and it's not necessary because you can simply take a
high quality multi (which, in my considered opinion, is not Theragram,
Centrum, One-A-Day et al). If one is deficient in chromium it is a safe
bet that they are also deficient to varying degrees in other nutrients
as well, which is why I do not recommend taking a chromium supplement
long term to ensure adequate chromium levels; an efficacious,
high quality multi is recommended.

To help determine if what you are experiencing when you
eat a sweet fruit meal is actually melon-belly, get a bottle of chromium
picolinate and take the recommended dose for two weeks (usually 200-300
mcg). Then try eating a meal of sweet fruit (and be at ease when you eat
it; if you are worried about a potential reaction, this may interfere
with proper digestion because worry is a strong emotion, and strong emotions
and digestion cannot take place at the same time, so it is digestion that
usually suffers). And while you are replenishing your chromium stores
(absorbed chromium is stored in the liver, spleen, soft tissue, and bone)
this would not be a good time to test to see if this is working by eating
those foods that cause your discomfort. Meaning, try to stay away from
those foods that cause your discomfort while you're building up your chromium
level, then after two weeks, reintroduce those foods while making sure
not to overeat on them of course.

When I did this "study" on myself, I tried eating
watermelon on Days 1 through 5 of supplementation, and it took almost
five days for there to be zero melon-belly. I can go into the "whys"
of this, but that is beyond the scope of this article (but if you think
about it, you can probably figure out why for yourself... some of this
is not rocket science, it's just common sense, requiring only a rudimentary
working knowledge of your blood sugar regulatory system, which any layperson
can acquire, assuming they care enough about their health).

After Day 5 I was able to eat all the watermelon I wanted
with no adverse reaction. People who have a more severe "case"
of melon-belly might need to take the chromium a little longer before
it will be effectual (again, you can probably figure out why); up to two
weeks may be necessary. I also tried an experiment where I over-ate on
watermelon (over-eating is normally not a good thing to do, but I was
curious). The only result was a "I ate way too much watermelon"
feeling, but no signs of any melon-belly.

I also tried stopping the chromium supplementation to
see how long it would take for the melon-belly to return (keep in mind,
the supplemental chromium is not "curing" anything, it is merely
providing enough for the task at hand). After about three days, the melon-belly
started to return, mildly at first, and then after about five days, it
was back to its previous level. I started taking the chromium supplement
again to verify my previous results, and in about three days no more melon-belly.
I now prevent melon-belly just fine by the daily use of this
nutritional adjunct to my diet.

Here's what's going on

The trace mineral chromium is a key player in blood sugar
metabolism. I'm not saying that chromium is the only nutrient needed
for this process, but it plays a pivotal role, just as iodine is key to
proper thyroid function.

If there is not enough chromium in your diet, blood sugar
metabolism can be adversely affected. And keep in mind that another reason
people complain about melon-belly after switching to a diet high in fruit
is that the more simple sugar you intake (like from fruit), the more chromium
is required for processing, because of increased chromium excretion in
the urine. And when people start adopting a very healthy diet, they often
start looking at making improvements in other areas of their lives, and
if they start a vigorous exercise program (which is a great idea) this
raises their chromium requirement, which may also tip the scales predisposing
them to melon-belly. So what I'm saying is: the healthier a life you're
living, the more important chromium is to the proper functioning of your
body.

I've also seen chromium play an important role with people
who I've helped with the resolution of their diabetes. There have been
some folks who did all the right things to be able to get rid of their
type 2 diabetes (low fat diet, exercise, etc) and could lower their insulin
or med requirement, but not eliminate it until they added some
supplemental chromium to their diet.

In the 1960's there were hospitalized patients (who
were fed intravenously) who showed signs of diabetes (including weight
loss, neuropathy, and impaired glucose tolerance) until chromium was
added to their feeding solution. The chromium, added at doses of 150
to 250 mcg/day for up to two weeks, corrected their diabetes symptoms.
Chromium is now routinely added to intravenous solutions.

So, there is a definite cause-and-effect relationship
between chromium levels and blood sugar metabolism. And for some people,
when they change to a low fat, high sweet fruit diet (the diet all human
beings are designed to eat), if there's insufficient chromium in their
diet, they can manifest melon-belly to some degree.

And since candidiasis (an overgrowth of candida) can also
be caused by a handicapped blood sugar regulatory system, sufficient chromium
is key to resolving this as well.

If you're wondering why there may be insufficient chromium
in your diet, a good article and video is here.

Bottom line...

There is considerable interest in the possibility that
supplemental chromium may help to treat impaired glucose tolerance and
type 2 diabetes, but the official research to date is inconclusive. No
large, randomized, controlled clinical trials testing this hypothesis
have been reported in the United States. Nevertheless, this is an active
area of research... but if you're going to wait until there have been
multiple, peer-reviewed, double-blind, placebo controlled studies of thousands
of people for many decades, you'll likely be waiting a very long
time, especially when you consider that a simple fix for diabetes could
be shown to be a chromium supplement in conjunction with an improved diet
which would effectively kill the billion dollar diabetes industry.

If this "test" that I've outlined shows you
that it is indeed a lack of sufficient chromium in your diet that is causing
your melon-belly, I recommend that you not continue taking the chromium
product (it was just to help you "test the theory"), and instead,
take a high
quality multi. Why not just keep taking the chromium supplement? Think
of it this way: If you are low in sufficient chromium, what are the odds
that this was the only nutrient that you are low in? My research
tells me that it's a pretty safe bet that if you are low in one nutrient,
you are also low in others. If you haven't yet watched the above mentioned
video
and read the above mentioned article,
now would be a good time.

And if you suffer from what you think is melon belly,
but taking chromium does not help, then you are dealing with something
other than melon belly.

And if you're wondering why some fruits cause it more
readily than others, there are a few contributing factors: water content
of the fruit (affects the speed of sugar uptake into the blood), the fructose:glucose
ratio (they are processed differently), and obviously the chromium content
of the fruit itself. Combine all these with how much you're eating, how
fast you're eating it, and your chromium "status", and it can
be less than straightforward to diagnose melon belly.

I've attempted to give you enough information so that
you can try and determine, for yourself, if a lack of chromium is a cause
of your discomfort when eating a sweet fruit meal. If you don't feel comfortable
doing this "test" yourself, I strongly suggest you seek the
counsel of someone who understands the above mentioned info. Read my disclaimer
to see who I recommend. And remember, discomfort/pain from eating a meal
of just fruit can be caused by a number of factors, and possibly by a
combination of some of them; i.e. primary and secondary causes. So, insufficient
chromium may be one of the contributing factors in your case. My
point? Don't assume that your condition is caused by one singular factor.
With the exception of being in a nuclear power plant when there is a serious
accident, most health conditions are not caused by just one thing.

Q:
Some people may be very chromium deficient, so is there benefit
to taking 400 mcg of chromium the first few days for people who
are really struggling with severe melon belly?

A:
The recommended dose is 200 mcg a day; this is a maintenance dose.
You'd have to take 3,000 times that amount to cause clastogenicity
(chromosome damage). But just because taking 400 mcg a day (therapeutic
does) for two weeks is not likely to cause any of the overt symptoms
of a chromium overdose  such as bleeding in the digestive
tract, liver or kidney damage, and problems thinking or concentrating
 this doesn't mean that an amount that is way higher than
could be obtained from eating foods rich in chromium won't negatively
affect the body somehow. And just so you know, taking six times
the recommended dose (1,200 mcg a day) may cause symptoms of a chromium
overdose in some people.

So rather than try and rush the normalization of
the body's chromium levels by taking a higher than normal dose,
I recommend taking the recommended daily dose, not taxing the blood
sugar regulatory system by eating no sweet fruit or small amounts
of sweet fruit eaten slowly with some greens, and wait two weeks
for the body's chromium levels to normalize in a normal way.

But it could be theorized that if symptoms of melon-belly
are severe, this could indicate that the person's chromium stores
are very low, so that taking 400 mcg for a week or two could
be a prudent thing to do, then 200 mcg from that point forward.
(Few serious adverse effects have been linked to high intakes of
chromium, so the Institute of Medicine has not established a Tolerable
Upper Intake Level (UL) for this mineral.)

Time to read between the lines

From NHI (National Institutes of Health) Office
of Dietary Supplements

"Chromium deficiency impairs the body's ability
to use glucose to meet its energy needs and raises insulin requirements.
It has therefore been suggested that chromium supplements might
help to control type 2 diabetes or the glucose and insulin responses
in persons at high risk of developing the disease. A review of
randomized controlled clinical trials evaluated this hypothesis.
This meta-analysis assessed the effects of chromium supplements
on three markers of diabetes in the blood: glucose, insulin, and
glycated hemoglobin (which provides a measure of long-term glucose
levels; also known as hemoglobin A1C). It summarized data from
15 trials on 618 participants, of which 425 were in good health
or had impaired glucose tolerance and 193 had type 2 diabetes.
Chromium supplementation had no effect on glucose or insulin concentrations
in the non-diabetic subjects nor did it reduce these levels in
subjects with diabetes, except in one study. However, that study,
conducted in China (in which 155 diabetics were given either 200
or 1,000 mcg/day of chromium or a placebo) might simply show the
benefits of supplementation in a chromium-deficient population."

Okay, let's keep in mind that the processed foods
many people eat are fortified with certain nutrients found to be
lacking in the diet... chromium is one of them. So is it possible,
when we move away from a diet filled with processed (fortified)
foods to a diet of whole, fresh, unprocessed (unfortified) foods
that come from an agri-based food supply system, that we may come
up short in certain nutrients? My research shows it's more than
possible, it's probable.

Some other chromium info to consider if diabetic

Chromium supplementation is most important for people
with diabetes. Many subjects with type 2 diabetes have faulty chromium
metabolism, due to inadequate intake, decreased absorption and increased
loss. Current data show a strong correlation between diabetes and
low levels of chromium in serum, hair, and toenail tissues. For
these reasons, chromium supplementation on the order of 1,000 mcg
per day has been recommended to provide significant clinical benefit
in diabetes. The dose for non-diabetic individuals is in the range
of 200-500 mcg per day. A recent study showed that chromium picolinate
does not induce chromosomal damage at doses up to 2,000 mcg per
kilogram of body weight (Komorowski et al., 2008), which is close
to 50,000 times the dose recommended for diabetes subjects.

No other chromium supplement shows the consistent
benefits that chromium picolinate does, especially at higher doses
for subjects with diabetes. Considering its compelling safety profile,
chromium picolinate is an inexpensive and uniquely efficacious supplement
to help control the high cost of diabetes treatment. It makes no
sense to experiment with chromium supplements that have limited
research when the stakes are so high.

Some info about the different forms of chromium

The two organic forms of chromium  chromium
picolinate and chromium polynicotinate (aka "GTF") 
are both well absorbed. I prefer chromium picolinate (which is chelated
with picolinic acid) over polynicotinate preparations (chelated
with niacin). Although chromium polynicotinate is claimed to be
well absorbed, I do not recommend it because it can cause flushing,
dizziness and hyperpigmentation; these undesirable side effects
are caused by the niacin, and if you're taking a supplement that
contains niacin already, this is another reason to go with chromium
picolinate.

Several studies have shown that chromium picolinate
is significantly better absorbed than other chromium forms in animal
and human studies (Anderson et al., 2004; DiSilvestro and Dy, 2005).
And there is data that suggests that chromium polynicotinate is
actually poorly absorbed.

The other forms of chromium  like chromium
chloride  should not be considered. They appear in super cheap
supplements.

And lastly, be aware of the misinformation

It should be noted that some raw food educators,
such as Doug Graham, maintain that chromium deficiency isn't a contributing
factor to melon belly, yet they also say that we just don't know
what does cause it. But both statements are false. The cause is
known. I put forth a hypothesis based on what we do know about blood
sugar metabolism (since the effect was similar to low blood sugar),
the hypothesis was tested using the scientific method, and the hypothesis
was proven to be correct.

So why do some raw food educators  who are
aware of my findings  continue to state that it's not a chromium
insufficiency? If they are also an educator who teaches that we
can get enough of all the nutrients our body's require for optimal
functioning if we just eat a raw diet of organic fruit and greens,
this would explain why they would be against anything that would
imply that we would need to take a nutritional supplement. But this
lovely notion of "Once you start eating enough fruits and vegetables
you don't have to worry about nutrition" (ala Doug Graham)
is simply not true. So some educators can draw erroneous conclusions
based on their beliefs and biases, and therefore make recommendations
that don't square with reality. Fortunately they are not all like
that... there are some outside-the-box health educators who also
think outside-the-box, and do not allow philosophies or biases to
color their judgment when giving thought to various health issues.